Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/9285
Title: Procalcitonin is useful in identifying bacteraemia among children with pneumonia.
Authors: Carvalho, Cristiana Maria Costa Nascimento
Cardoso, Maria Regina Alves
Barral, Aldina Maria Prado
Araújo Neto, César Augusto de
Guerin, Sylvie
Saukkoriipi, Annika
Paldanius, Mika
Vainionpaa, Raija
Lebon, Pierre
Leinonen, Maija
Ruuskanen, Olli
Genfrel, Dominique
Affilliation: Universidade Federal da Bahia. Escola de Medicina Veterinária. Departamento de Pediatria. Salvador, BA, Brasil
São Paulo University. Faculty of Public Health. Epidemiology Department. São Paulo, SP, Brasil
Universidade Federal da Bahia. Escola de Medicina. Departamento de Diagnóstico de Patologia. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil
Universidade Federal da Bahia. Escola de Medicina Veterinária. Departamento de Diagnóstico de Imagem. Salvador, BA, Brasil
Paris Descartes University. St Vincent-Cochin Hospital. Paris, France
National Institute for Health and Welfare. Oulu, Finland
National Institute for Health and Welfare. Oulu, Finland
University of Turku. Virology. Turku, Finland
Paris Descartes University. St Vincent-Cochin Hospital. Paris, France
National Institute for Health and Welfare. Oulu, Finland
University of Turku. Paediatrics Department. Turku, Finland
Paris Descartes University. St Vincent-Cochin Hospital. Paris, France
Abstract: Empirical antibiotic use is prescribed in managing children with pneumonia worldwide. We assessed the usefulness of procalcitonin (PCT) and interferon-alpha (IFN- α ) in differentiating viral from bacterial pneumonia. Among 159 hospitalized children, pneumonia was diagnosed based on clinical complaints plus pulmonary infi ltrate. Aetiology was investigated for 9 viruses and 4 atypical and 3 typical bacteria. PCT and IFN- α were measured in the serum sample collected on admission. Eight patients had bacteraemic infections, 38 had non-bacteraemic typical infections, and 19 patients had atypical bacterial infections. Viral and unknown aetiology was established in 57 (36%) and 34 (21%) cases, respectively. Three patients with bacterial infection without collected blood culture were excluded. IFN- α (IU/ml) was detectable in 20 (13%) cases. The difference among median PCT values of the bacteraemic (4.22; 1.56 – 7.56), non-bacteraemic typical bacterial (1.47; 0.24 – 4.07), atypical bacterial (0.18; 0.06 – 1.03) and only viral (0.65; 0.11 – 2.22) subgroups was signifi cant ( p 0.02). PCT was 2 ng/ml in 52 (33%) cases. The presence of IFN- α was associated with PCT 2 ng/ml (90% vs. 64%, p 0.02). The negative predictive value (95% confi dence interval) of PCT 2 ng/ml was 95% (89 – 100%), 89% (78 – 100%), 93% (85 – 100%) for differentiation of bacteraemic from viral, atypical bacterial and nonbacteraemic typical bacterial infection, respectively, and 58% (49 – 68%) for differentiation between bacterial and viral infection. PCT may be useful in identifying bacteraemia among children hospitalized with community-acquired pneumonia. IFN- α was uncommonly detected.
DeCS: Bacteriemia/diagnóstico
Calcitonina/sangue
Pneumonia Bacteriana/diagnóstico
Pneumonia Viral/diagnóstico
Precursores de Proteínas/sangue
Bacteriemia/sangue
Pré-Escolar
Infecções Comunitárias Adquiridas/sangue
Infecções Comunitárias Adquiridas/diagnóstico
Diagnóstico Diferencial
Feminino
Humanos
Lactente
Recém-Nascido
Interferon-alfa/sangue
Masculino
Pneumonia Bacteriana/sangue
Pneumonia Bacteriana/microbiologia
Valor Preditivo dos Testes
Estudos Prospectivos
Curva ROC
Reprodutibilidade dos Testes
Estatísticas não Paramétricas
Issue Date: 2010
Publisher: Informa Healthcare
Citation: NASCIMENTO-CARVALHO, C. M. et al. Procalcitonin is useful in identifying bacteraemia among children with pneumonia. Scandinavian Journal of Infectious Disease, v. 42, n. 9, p. 644-649, 2010.
DOI: 10.3109/00365541003796775
ISSN: 1651-1980
Copyright: open access
Appears in Collections:BA - IGM - Artigos de Periódicos

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